Provider Demographics
NPI:1467891044
Name:PEARSON, NICOLE ASHLEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:ASHLEY
Last Name:PEARSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15242 NORTH HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442
Mailing Address - Country:US
Mailing Address - Phone:248-634-2314
Mailing Address - Fax:
Practice Address - Street 1:15242 N HOLLY RD
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-1141
Practice Address - Country:US
Practice Address - Phone:248-860-2517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302039317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist